Wednesday, February 22, 2012

Responding to Crisis

Depression is a common psychiatric disorder found in children, adolescents, adults and the elderly (Sharp & Lipsky, 2002). Symptoms of depression include feelings of stress, sadness, hopelessness and agitation (Monroe, et al., 2007). Identifying and assessing clients with severe depression who may be suicidal is important in order to provide the best care and course of treatment.

In my practice, if a client presents with suicidal ideation, the following information is discovered: (1) thoughts of suicide, (2) plan for committing suicide, and (3) accessibility for implementing suicide plan.

If an individual is identified as “low risk” then it is understood by the counselor that the client does not mean to harm self, has no history of suicide attempts, is not a substance abuser and is not physically abused.

An individual identified as a “moderate risk” may have a vague plan of self harm, accessible means of committing suicide, has reported suicidal ideation, and is in a violent or abuse environment.

In order to be identified as “high risk” of committing suicide, an individual would report, describe or detail a specific plan of suicide, possess the mean of committing a suicidal act, have attempted suicide I the past, is substance dependent, and is in a physically violent environment.

Following the above referenced suicide risk assessment, an individual identified as “moderate” risk would complete a suicide contract, identify and develop a support group of friends or family members, and receive treatment for depression with a referral to a physician to determine the need for anti-depressants.

With a high risk client safety is the top priority. The procedures involved with a high risk client include (1) complete a suicide contract, (2) contact individual, identified by client, who will act as client/counselor liaison, (3) encourage client to report to a local in-patient treatment facility.

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